Socioeconomic inequalities in food outlet access through an online food delivery service in England: A cross-sectional descriptive analysis

Abstract

Online food delivery services facilitate ‘online’ access to food outlets selling food prepared away-from-home. Online food outlet access has not previously been investigated in England or across an entire country. Systematic differences in online food outlet access could exacerbate existing health inequalities, which is a public health concern. However, this is not known. Across postcode districts in England (n = 2118), we identified and described the number of food outlets and unique cuisine types accessible online from the market leader (Just Eat). We investigated associations with area-level deprivation using adjusted negative binomial regression models. We also compared the number of food outlets accessible online with the number physically accessible in the neighbourhood (1600m Euclidean buffers of postcode district geographic centroids) and investigated associations with deprivation using an adjusted general linear model. For each outcome, we predicted means and 95% confidence intervals. In November 2019, 29,232 food outlets were registered to accept orders online. Overall, the median number of food outlets accessible online per postcode district was 63.5 (IQR; 16.0–156.0). For the number of food outlets accessible online as a percentage of the number accessible within the neighbourhood, the median was 63.4% (IQR; 35.6–96.5). Analysis using negative binomial regression showed that online food outlet access was highest in the most deprived postcode districts (n = 106.1; 95% CI: 91.9, 120.3). The number of food outlets accessible online as a percentage of those accessible within the neighbourhood was highest in the least deprived postcode districts (n = 86.2%; 95% CI: 78.6, 93.7). In England, online food outlet access is socioeconomically patterned. Further research is required to understand how online food outlet access is related to using online food delivery services.

Investigating experiences of frequent online food delivery service use: a qualitative study in UK adults

“…Doing so would help address concerns that these services increase access to food prepared out-of-home [ 4 , 13 ]. Interventions of this nature could be particularly important in more deprived areas that have the highest number of accessible food outlets across multiple purchasing formats [ 16 , 51 ].…”

“…Each of these domains apply to takeaway food access through online food delivery services. In 2019, the number of food outlets accessible through the leading online food delivery service in the UK ( Just Eat ) was 50% greater in the most deprived areas compared with the least deprived areas [ 16 ]. Furthermore, adults living in the UK with the highest number of food outlets accessible online had greater odds of any online delivery service use in the previous week compared to those with the lowest number [ 17 ].…”

Associations between online food outlet access and online food delivery service use amongst adults in the UK: a cross-sectional analysis of linked data

“…We have previously shown that online food delivery services are an additional purchasing format that increase overall access to food outlets selling food prepared away-from-home, but especially in areas of England with the greatest deprivation [ 63 ]. This means that whilst these services offer additional opportunities for consumption of energy-dense and nutrient-poor food amongst all populations, they may also exaggerate inequalities in the consumption of less healthy diets and related health outcomes.…”

Describing and characterising on‐demand delivery of unhealthy commodities in New Zealand

“…19 These at-risk population groups may be disproportionately impacted by on-demand delivery services, particularly if unhealthy food offerings are targeted at these neighbourhoods. 12,20,21 Traditional policies are based on the 'built' food, alcohol and nicotine environment, where measures such as restricting the number of outlets in a location are employed to reduce consumption. Ondemand delivery destabilises these policies by eliminating geographical barriers to access.…”

“…Socioeconomically deprived areas, where Māori and Pasifika communities are over‐represented, experience a double burden of lower income and a higher density of fast‐food outlets, 17,18 which interact as determinants of harm 19 . These at‐risk population groups may be disproportionately impacted by on‐demand delivery services, particularly if unhealthy food offerings are targeted at these neighbourhoods 12,20,21 . Traditional policies are based on the ‘built’ food, alcohol and nicotine environment, where measures such as restricting the number of outlets in a location are employed to reduce consumption.…”